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Thursday, December 5, 2019

Did You Though?

Saying "I watched him send it" is like saying "I watched him paint my portrait".
Sure, you sat there for the portrait.
Sure, he looked at you, dipped his brush in the colours on his palette, and placed some strokes on the canvas.
But did you actually SEE what he painted?
Especially odd if your artist was Dali, Escher, or Picasso.

Sure, you sat there facing him while he tapped his fingers on some keys on the computer.
But did you actually SEE what he typed?
Did you watch him select MY pharmacy?
Did you actually SEE the confirmation on the screen?
He could have been making lineup changes to his fantasy teams, moving the money from your visit into his "new car fund", or making dinner reservations.
Especially odd if you see Dr. Acula or Dr. Lechter.

"We only see what we want to see."

Monday, December 2, 2019

Boss Woman

CP's Partner: Did you listen to last month's conference call?
CP: I heard it, but I did not listen to it.
CPP: Did you hear Boss Lady Orating Words Making Excuses?
CP: I try to tune her out. If she says something important, I tell the techs to say BLOWME is calling on you. What did BLOWME say this time?
CPP: She issued one of her more contradictory statements to date.
CP: Do tell.
CPP: You know how we continue to lose hours and we can't seem to get ahead and our complaints are on the rise?
CP: Nope. Hadn't noticed. But please, continue for the others.
CPP: She said "I'm tired of hearing about staff and hour shortages".
CP: Please tell me someone said "Good! I'm tired of answering to patients about why we are behind, BLOWME. It's about time you finally did something about it!"
CPP: Alas, no one did. You really need to pay attention to these calls.
CP: Can't wait to see what next month's call is about. She reduced our staff budget by 33% during the holiday week and 10% for the week after. Our volume will not go down by the same amount just because some corporate pencil pusher thinks it will. I have yet to work a Thanksgiving week that fills 33% fewer prescriptions than a normal week.
CPP: Yeah. And let's not forget that the Monday after Thanksgiving is often one of the busiest days of the year. Good time to make cuts.
CP: Maybe they forgot the holiday is the very end of the month? Or that the following Monday, it's the first of the month?
CPP: <so cash your checks and get up!> This is how they contribute to their Christmas Club fund at corporate.
CP: Oh well, next time BLOWME decides to tell me she doesn't want to hear it, expecting it to just go away, I will remind her she can't just put her fingers in her ears, close her eyes, and mutter "lalalalalalalalalalalalala"and everything will get better. In fact, I will probably say, BLOWME, if you can ignore that which you no longer wish to hear, then I no longer wish to hear you complain about my performance, so I too will employ your tactics and ignore them. You're such a good leader, BLOWME, that you have taught me how to be a better boss in my own store so, BLOWME, I shall follow your example. Good day, BLOWME!

To quote a favourite author of mine, Caitlin Doughty, "But it's also reality, and reality doesn't change just because you don't like it."

Friday, November 22, 2019

Order Up

Uber-Tech: I'm phrustrated, CP
CP: As am I. Why don't anal, banal, and canal rhyme?
UT: I loathe you.
CP: Sorry. Continue.
UT: Why are patients not prepared when they come to the pharmacy? Especially the drive-thru?
CP: Is this rhetorical? Or a metaphor for life?
UT: A metaphor. I need to learn your language to communicate with you.
CP: Proceed.
UT: A patient orders a refill and we confirm a refill is ready when they arrive.
CP: Okay.
UT: They then have the nerve to ask "where are my other 3 medications?" or complain that we filled the wrong one.
CP: True. This happens with pretty much every interaction. What's your analogy?
UT: This would be like going to Chik-Fil-A and ordering a Spicy Chicken sandwich and a lemonade. When the perky cashier repeats your order immediately back to you ("that's one spicy chicken sandwich and a lemonade") you confirm it and await its delivery. THEN, when the order is set in front of you, mere seconds after being placed, you proceed to argue and complain about its inaccuracy.
"Where are my nuggets? And the waffle fries? And my chicken strips? Every time I come here you can't get it right!"
I just don't understand how patients become such vacuous oafs when they arrive at the pharmacy.
CP: I see the rest of the conversation happening as -
   Impatient Mad Patron: "Why didn't you give me waffle fries?! It's not a meal unless you include the      waffle fries!"
   UT: You didn't order waffle fries, or a meal.
   IMP: I never have this problem at Wendy's!
   UT: Well this isn't Wendy's and they don't serve waffle fries, so there's that. If you could just park in the little "drive-thru parking" spot to your left, I'll get those waffle fries right out to you.
   IMP: Now I have to wait? Nope. I'm sitting right here.
   UT: Well either way, you're going to wait. It's either here, blocking my drive-thru, or up ahead where I will bring them out to you.
UT: Yeah. Except that doesn't happen at Chik-Fil-A. Or anywhere else for that matter.
CP: Manners and decorousness seem to evaporate as soon as patients near a pharmacy. I like your new term for them, Vacuous Pharmacy Oafs.
UT: Thanks. I think we're going to have to start referring to them that way whenever we have a call/issue/complaint. "CP, there's a VPO for you at the DT".
CP: Love it!
UT: Oh, and I have one of those anagrams for you too.
CP: Go on.
UT: You know all those vacation commercials for Sandals?
CP: Yes. Quite picturesque.
UT: If you rearrange the letters you get "ASSLAND".
CP: Nice. Changes my image of those honeymoon ads.
UT: Sounds like Eden for all those VPO's.
CP: Indeed.

Monday, November 18, 2019

I Know What I Need

CP: Oh baby, I. . . I know what I need.
Uber-Tech: Why are you bastardizing songs again? 
CP: For this little vignette

CP: CP's Pharmacy. This is CP, Proprietor and Head Pill Pauper. How may I help you?
Can't Understand News That I'm Sharing Here: I'm calling to see if my prescription is ready. 
CP: Over the phone? 
CUNTISH: Yes. 
CP: How can you "see" if it's ready over the phone? You should come in for that. 
CUNTISH: I wish to know if it is ready. 
CP: AH. That makes more sense. Name, DOB, favourite author?
CUNTISH: Um. CUNTISH, 5/5/75, Seuss?
CP: Got it. Thanks. Unfortunately I have nothing ready for retrieval. 
CUNTISH: Why the hell not? 
CP: Many reasons, I suppose: We didn't feel like filling anything for you; we blackballed your order; you didn't call it in; you opted out of on-time refills; you're out of refills; the prescriber didn't call in anything yet; you have the wrong pharmacy; it's Wednesday; Mars isn't in retrograde; I have a headache; APhA still sucks. . . 
CUNTISH: Yeah yeah yeah. Just fill my prescription. 
CP: Now that you have called and politely requested I prepare your prescription, I shall fill it forthwith. 
CUNTISH: You mean to tell me that if I hadn't called, you wouldn't have filled it? 
CP: Pretty much that's exactly what I said. That is how the system works. 
CUNTISH: <scoffs> Unbelievable!
CP: Why unbelievable? I don't send money to places that don't send me bills. Even babies cry for attention. They cry to be fed, to be changed, to be held and it's up to you to determine what they need when they cry. A happy, quiet baby is usually sleeping and doesn't need to be stirred and asked "are you hungry? do you need changed? wanna play?" or it gets a little angry and now you have to phix a problem you created. Unless and until you cry to be fed, I'm not going to harass you begging to fill your prescriptions. Now a corporation may text and call and email and do drone flyovers begging for your business, annoying you, but a happy, quiet you is not of my concern. Unlike a newborn, you are fully capable of operating the technology required to contact me, use your words, and ask for a refill when you notice your ba-ba is empty. Grow up!
CUNTISH: <click>

UT: Wow. Nicely done. 
CP: Adulting is hard. I often wonder what these people do when the supplies in their refrigerators are exhausted. Or the gas in their cars. 
UT: Toilet paper. Can't you just hear them in their bathrooms screaming for help, or calling Charmin asking why they weren't told they only had a single square to spare and how last night was Taco Tuesday?
CP: I should rerun my "But Her Refrigerator Was Still Running" post. 
UT: Still one of my faves. 


Wednesday, November 13, 2019

I Felt Better

CP: CP's Palace of Pills and Potions. How may I help you? 
Not Enjoying Withdrawal Symptoms: I have a problem. 
CP: You have a problem? She turned me into a newt!
NEWS: A newt? 
CP: I got better. Anyway. You were saying? 
NEWS: I was taking medication for my sciatica. And it helped. 
CP: Good news. What's the problem with it working? 
NEWS: I felt better so I stopped taking it. 
CP: I see. Let me guess. . . it stopped working when you stopped taking it? 
NEWS: Yes! Now I don't feel as good. And I have these terrible withdrawal symptoms. 
CP: Makes sense.  
NEWS: Why? I got better. 
CP: You weren't treating the disease, you were only blocking the symptoms. You got better BECAUSE you were taking the medication. You quit taking the medication and, ipso facto, it stopped working.  
NEWS: How's that? 
CP: Pretend you're a car. 
NEWS: What kind? 
CP: A Yugo. Doesn't matter. You fill it with gas and drive around town. You stop by the local pharmacy, then the grocer, then head off for a picnic in the country. On your way home, the gas tank runs dry and the car stops. Is there a correlation between the gas tank and why the car stopped working? 
NEWS: So you're saying that because I didn't put my medication in me, I didn't run?
CP: Succinctly, and oddly, disturbingly, visually stated. 
NEWS: Can I start taking it again? 
CP: Fill 'er up. 

Uber-Tech: Is there any situation you can explain to a patient without a scenic analogy? 
CP: No. Why be boring? Besides it's easier for people to comprehend something they already understand than it is to teach them something novel for which they have no prior experience to apply. 
UT: You are rather wordy. 
CP: I prefer loquacious. And she had her "aha!" moment. 
UT: We're talking away. 

Monday, November 11, 2019

What's Right Is Right

CP: You know how we see prescriptions from prescribers that make us look at each other and ask if they even know what they are prescribing?
CP's Partner: Yes. Or if they just heard about it on TV, or from a patient who heard about it on TV and the prescriber shrugs and says "let's give this a go".
CP: Right. On the flip side of that, we have medications that we just KNOW the correct way they should be written.
CPP: True. There are a certain number of medications that we can tell by a glance are correct, are completely boffo, or that need a little of our professional massaging. We are the experts after all. What happened to initiate this conversation, again?
CP: My last weekend. I had another of those arguments with central processing.
CPP: Is this another one of those "not to denigrate another professional, but. . ." issues?
CP: It is. I like to think that we as pharmacists know the same things. Certainly there are specialists within each practise location. An expert in retail may be a novice when transitioning to hospital, or the reverse could be true. But I would expect a similar level of competence from a peer in my practise location.
CPP: Okay. What happened?
CP: You know how the central pharmacists review our prescriptions after they've been typed?
CPP: Right. They have a few dozen stores they help with verification.
CP: Since we aren't supposed to be typing and checking our own work, I entered a prescription so it would be worded correctly as the e-script left a lot to be desired.
CPP: Makes sense. You are the responsible pharmacist at the end of the day. I'm guessing this didn't go well?
CP: Nope. It was rejected. By a Pharmacist. Because the directions I typed did not match verbatim what was sent on the e-script.
CPP: Okay.
CP: To make matters worse, I sent it back through, he rejected it again. I sent it a third time, he again rejected it. Finally, I selected "local" and finished it myself.
CPP: I'm guessing that's not the end?
CP: No. I took the package insert out of the box, enlarged the directions, then faxed them to him and his boss and our boss.
CPP: What did she say?
CP: Nothing. Just shrugged and said "we have no control over the central processing center".
CPP: So they are making more work for us instead of helping?
CP: That's the point.
CPP: So by now everyone wants to know what the medication was.
CP: It was for NTG 0.4mg sl tabs. The e-script directions were "1 tab every 5 minutes for chest pain".
CPP: Which is wrong.
CP: Which I corrected, as always, to: "Dissolve 1 tablet under tongue every 5 minutes up to 3 tabs in 15 minutes as needed for chest pain. No relief, call 911".
CPP: Which is in the package insert.
CP: Right. Can't you just see someone popping an entire bottle of 25 tablets, getting no relief, and suffering a heart attack while experiencing a wicked headache?
CPP: Okay. This then begs the question we have to ask everyone: What other medications do you just know how to type correctly, e-rx directions be damned?
CP: I'll give you three.
1. Lidocaine 5% patches - apply patch(es) to area and leave on for 12 hours then remove for 12 hours.
2. Clotrimazole Troches - Slowly dissolve 1 tablet in mouth.
3. Miacalcin NS - Use 1 spray in 1 nostril every day. Alternate nostrils daily.
CPP: Yeah, that last one gets entered incorrectly all the time.
CP: Can't you just see some pharmacists out there calling on these?
CPP: What's worse is them not fixing these mistakes or missing them altogether because they've never seen them written correctly; or weren't taught these during their retail experiences.
CP: Yeah. The preceptor site was either too busy or they used the students as free labour instead of teaching them the ways of the phorce.
CPP: I have one more to add.
CP: You have the phloor.
CPP: SL vs ODT. We receive prescriptions all the time that say "Take one tablet by mouth" or that confuse the two terms.
CP: What's the correct way to enter these directions, call center and e-script directions be damned?
CPP: SL is sublingual which literally translates to "under the tongue". ODT, or Orally Disintegrating Tablets should be remembered as dissolving On Da Tongue. ODT. Get it?
CP: Nice.
CPP: With that in mind, what else do you have to offer, oh mighty phans of CP?

Monday, October 28, 2019

Stroke Me = Troche

CP: Are you familiar with the 80's hit The Stroke, by Billy Squire?
ME: Of course.
MYSELF: Natch. Why?
CP: You know how the chorus repeats?
Stroke Me
Stroke Me
Stroke!
Stroke!
Stroke Me
Stroke Me
Stroke!
Stroke!
ME: Yes.
MYSELF: Where are you going with this?
CP: What's the name of a dome-shaped cover, usually for food dishes?
ME: Cloche.
CP: And another name for a lozenge?
MYSELF: Troche.
ME: TRO-Key
CP: And now that song reminds me of two people arguing over the proper pronunciation of that word.
TRO-Key
TRO-Key
TrOsh!
TrOsh!
TRO-Key
TRO-Key
TrOsh!
TrOsh!
ME: Has anyone ever told you there's something wrong with you?
CP: Yes. My techs and interns every single day.
MYSELF: Your brain works in mysterious ways.
CP: It does. I can either embrace it or ignore it. I choose to share it.
MYSELF: I still say it's pronounced TrOsh.
ME: TRO-Key!
CP: You're both correct. TRO-KEY is the first pronunciation, but TrOsh is listed as a British variant.
MYSELF: Thanks for ending that debate. Now does that make you a Dooshbag?
ME: Or a Doo-key-bag?
CP: I'm team Tro-Key.

Friday, October 25, 2019

Dear Diary

Dear Diary:

Flu Shot Week 9:
ME: So many people have promised to come back for shots and not returned that I am soon to abandon all hope of making the bosses happy. I feel jilted. I will forever be on the bottom.
CP: Bottom isn't bad. It means you're good at something.
ME: What?
CP: Screwing up.
ME: <moans>
CP: Now you got it. But that gave me an idea.
MICE ELF: How did that give you an idea?
CP: Promise rings.
ME: Huh?
CP: It's another measurable metric for Corporate Overlords to hold over your head. Promise Rings. You give them to patients and they swear a solemn vow to be loyally yours in flu vaccination. They will repeat after you: "With this ring, I do hereby vow to return to you tomorrow, next weekend, or next year and receive my inoculation."
MICE ELF: Nice. You could use that in lieu of a waiting list for other shots.
ME: Sounds like more heartbreak for me. I can just see it now, people skulking by the counter, surreptitiously sliding their rings behind the register in an effort to break their promise with me.
MICE ELF: You should be used to the stealth breakup by now. Anyway, the CO would still expect you to make good on those promised shots.
CP: Something else for you to screw up. See! You are good at something! And what's the best part about being on the hourly conference calls berating you for not administering enough vaccines?
ME: What?
CP: You're not giving shots because you're on the phone telling them why you're not giving shots!
MICE ELF: It's like when they ask why your complaints have risen over the last month and you remind them they cut your hours and you are now in peak shot season.
CP: They will wave a dismissive hand and blame you because they set you up for failure! They EXPECT you to fail! It's genius. In this way, not only are you meeting their expectations, you are exceeding them! Genius!
ME: Well, when you put it that way. . . Promise rings, huh? I like it.
CP: Just don't get too attached. People seem to be loyal to wherever they happen to be at that exact moment.
ME: But they promised.
CP: And with this ring, they shall return.
MICE ELF: Maybe we could repurpose used Nuvarings?
CP: One ring to rule them all?
ME: Gross.